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排卵期也會(huì)出血？這不是什么大問(wèn)題

出處：網(wǎng)絡(luò)收集 日期：2024-06-30 10:37:12 編輯：秩名

前幾天，女兒?jiǎn)栁遥?ldquo;我們單位一個(gè)女孩經(jīng)常會(huì)下腹痛，白帶的顏色還很不好，會(huì)不會(huì)是附件炎啊。要么就是其他啥病，這都結(jié)婚兩年了，也一直沒(méi)孩子。” 
 
我仔細(xì)詢問(wèn)后，明確告訴她，這只是排卵期的癥狀之一，醫(yī)學(xué)上稱為排卵期出血及排卵期腹痛。
 
有些女性會(huì)在排卵期時(shí)出現(xiàn)肛門(mén)墜脹或一側(cè)下腹痛的癥狀。這是因?yàn)槌墒斓穆炎訌穆殉脖砻媾懦鲆獩_破包裹卵子表面的一層薄膜狀的濾泡，濾泡內(nèi)的少量液體就會(huì)流入盆腔的最低部位，女性會(huì)感到肛門(mén)有輕度下墜感，同時(shí)也有一側(cè)下腹輕痛。這就是醫(yī)學(xué)上所說(shuō)的排卵期腹痛。
 
但也有些人的癥狀比較嚴(yán)重，會(huì)出現(xiàn)咖啡色白帶或在排卵期有少量出血的狀況，有的出血會(huì)連續(xù)2～3天，甚至一星期，更為嚴(yán)重者，可淋漓至下次月經(jīng)來(lái)臨。這是因?yàn)?，卵泡從卵巢中排出時(shí)，會(huì)把卵巢壁撕破，引起局部出血。通常這一點(diǎn)點(diǎn)血很快就在腹腔內(nèi)被吸收了。但也有少數(shù)女性，出血量比較多，血液就會(huì)經(jīng)過(guò)輸卵管、子宮、陰道流出體外，在內(nèi)褲上出現(xiàn)點(diǎn)滴樣的血跡，有的女性把它稱為“小月經(jīng)”，醫(yī)學(xué)上稱之為“排卵期出血”。
 
由于成熟的卵泡破裂排卵后，雌激素水平急驟下降，不能維持子宮內(nèi)膜生長(zhǎng)，引起子宮內(nèi)膜表層局部潰破、脫落，從而發(fā)生突破性少量出血，隨著卵巢黃體的形成，分泌出足量的雌、孕激素，使?jié)⑵频淖訉m內(nèi)膜表層迅速修復(fù)而出血停止，或者可能當(dāng)排卵期時(shí)，成熟的卵泡分泌較多的雌激素，導(dǎo)致子宮內(nèi)膜充血引起紅細(xì)胞漏出；也可能于輸卵管傘部攝卵時(shí)，將含血的卵泡液經(jīng)輸卵管逆蠕動(dòng)送至子宮腔再由子宮頸經(jīng)陰道流出。有研究稱，對(duì)有排卵的女性于月經(jīng)中期檢查宮頸管黏液時(shí)，發(fā)現(xiàn)約有60%在顯微鏡觀察下見(jiàn)到有紅細(xì)胞，而沒(méi)有肉眼可能見(jiàn)到的出血，這不屬病理現(xiàn)象。
 
排卵期出血是很多女性會(huì)出現(xiàn)的癥狀，大部分出血量少，有的僅為咖啡色分泌物，一般2～3天可自行停止。
 
事實(shí)上，排卵期出血最大的危害是可能會(huì)引發(fā)不孕不育。這個(gè)原理非常簡(jiǎn)單，如果妻子常年有排卵期出血或排卵期腹痛的癥狀，一般都會(huì)中止性生活，從而錯(cuò)過(guò)受孕時(shí)機(jī)，最終導(dǎo)致不孕癥的發(fā)生。事實(shí)上，排卵期出血期間確實(shí)應(yīng)該盡量避免性生活，因?yàn)榭赡軙?huì)造成感染。 
 
有很多排卵期出血也有可能是原發(fā)病引起的，比如月經(jīng)不調(diào)、宮頸糜爛、宮頸息肉、宮頸癌、子宮內(nèi)膜息肉、子宮黏膜下肌瘤、子宮內(nèi)膜腺癌等生殖道疾病也可引發(fā)排卵期出血癥狀。這時(shí)應(yīng)該先治療再進(jìn)行備孕，若治療痊愈后，完全可以正常懷孕。
 
而是否是非病理性的排卵期出血，可經(jīng)診斷性刮宮、基礎(chǔ)體溫測(cè)定（基礎(chǔ)體溫呈雙相，在低、高溫轉(zhuǎn)變時(shí)發(fā)生出血）、腹腔鏡檢查可確診。若癥狀較輕，則出血期間應(yīng)避免過(guò)度勞累，多休息；要保持局部清潔，防止感染；腹痛重時(shí)可給腹部熱敷；同時(shí)保持情緒穩(wěn)定。平時(shí)加強(qiáng)體育鍛煉，增強(qiáng)體質(zhì)。排卵期前后（一般在兩次月經(jīng)之間，基礎(chǔ)體溫上升之時(shí)），應(yīng)禁食辛、辣、燥等刺激性食品，以免使出血增多和時(shí)間延長(zhǎng)。
 
也有的患者只是偶爾一次的排卵期出血，有的出血量極少，點(diǎn)滴即凈，或?yàn)閹е袏A血，一般情況下極少達(dá)到月經(jīng)量。出血時(shí)可伴一側(cè)下腹脹痛不適或隱痛或疼痛明顯，甚至牽扯腰骸部及股內(nèi)側(cè)。癥狀出現(xiàn)可每月連續(xù)發(fā)生或隔月發(fā)生1次，有的人每年中有幾個(gè)月發(fā)生，有的人一生中只出現(xiàn)一次這種現(xiàn)象。這多是由于過(guò)度勞累或生病后免疫力低下，影響了內(nèi)分泌的平衡導(dǎo)致的，對(duì)身體沒(méi)有多大影響，一般不需要治療。如果經(jīng)常出現(xiàn)排卵期出血，則可能是內(nèi)分泌紊亂導(dǎo)致的，需要在醫(yī)生指導(dǎo)下，服用可以補(bǔ)充雌激素的藥物。如果出血多于正常月經(jīng)量，或時(shí)間超過(guò)5天，就需到醫(yī)院檢查，以排除陰道、宮頸、子宮內(nèi)膜及卵巢的病變。
 
對(duì)于非病理性排卵期出血，西醫(yī)一般建議己烯雌酚0.25～0.5mg／日，排卵前3天開(kāi)始服用，血止后1～3天停藥。
 
中醫(yī)也有相應(yīng)的治療方案，這都需要在醫(yī)生指導(dǎo)下治療及服用，而我這里只推薦幾個(gè)食療方案，僅供參考。
 
芹菜金針湯：干芹菜30克，金針菜15克，加水適量，煎湯服用，有清熱、涼血的功用。
 
芹菜藕片湯：鮮芹菜、鮮藕片各120克，油15克，精鹽少許，炒5分鐘，加水適量煮熟，調(diào)味后食用，可清熱、涼血。 
 
山藥枸杞粥：山藥、枸杞子各20克，大米60克，熬粥食用。有滋陰、止血之功。 
 
生地粥：生地30克，粳米60克。將生地洗凈切片，用清水煎煮2次，共取汁100毫升，將米洗凈加水適量煮粥，倒入藥汁再煮10分鐘后服用。有滋腎、涼血、止血之功用。
 
當(dāng)歸羊肉湯：羊肉1 000克，當(dāng)歸30克（如果能接受味道可以適當(dāng)加量至50克），紅棗若干，生姜30克。將生姜切絲，與上述材料一起用砂鍋燉煮，注意不要放鹽，煮2小時(shí)后即可，每日食用2次。
 
最后，又回到了大家最關(guān)心的問(wèn)題，排卵期出血究竟能不能懷孕。事實(shí)上，只是單純的排卵期腹痛，我建議備孕期的準(zhǔn)媽媽盡量不要錯(cuò)過(guò)這個(gè)排卵時(shí)機(jī)，這個(gè)時(shí)候是完全可以受孕的。
 
但是對(duì)于排卵期出血的朋友，無(wú)論是病理性的還是非病理性的，只要出血延續(xù)2天以上者，無(wú)論出血量多少，都應(yīng)該治愈后再同房，以防引起其他感染而給造人大計(jì)帶來(lái)新的困擾。但排卵期只是白帶的顏色微微有些變化（變成咖啡色），且次數(shù)不多的人，完全可以在排卵期同房，只不過(guò)應(yīng)盡量注意同房前的個(gè)人衛(wèi)生。

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